Examples of Healthcare Models and Theories
Lewin’s Change Theory: 3 steps to change # Unfreezing—act of “destabilizing old behaviors”, discarding old practices and behaviors # Moving—group switches and learns new behaviors/methods # Refreezing—return of stability or equilibrium to unit once new learned behaviors are established * Requires a “need” for change or driving force to recognize change needed (unfreezing) * Basis in democratic model—requires whole to participate for change to occur * Leaders/managers are key to recognition of needed change * (Ch 15, Bishop, S.—Theories of organizational behavior and leadership, pp. 339-354) Nightingale: value and establishment of quality control and management * Use of detailed records, assessments and outcomes of infection management * Use of findings to modify hospital policies/procedures * Establish guidelines for quality of patient care * Focus on eliminating environmental factors that irritate patients but go unnoticed by others resulting in best condition for healing for patient (p. 357) * (Ch 16, Anderson, P.—Theoretical approaches to quality improvement, pp. 355-373) Behavioral System Model: goal is to maintain/restore behavioral balance * Seven subsystems of behavior = achievement, affiliative, aggressive, dependence, sexual, eliminative, ingestive ** 4 main structural components to each subsystem * Drive/goal to maintain each subsystem * Normal behaviors = set used to meet subsystem * Options available to pt to meet subsystem * Action = the behavior resulting from previous three ** Each subsystem = function pt needs to master self/environment ** Nurse is there to help maintain balances * Goals of healthcare management are “to restore, maintain, or attain the patient’s behavioral system balance and stability and to help the patient achieve an optimal level of balance and functioning.” (p 393) * (Ch 17, Masters, K.—Models and theories focused on nursing goals and functions, pp. 377-405) Health Promotion Model * Model of pt behavior and what factors are needed to incite change * Health requires individuals’ character/experiences, behavioral variables (i.e. perceived barriers, self-efficacy, benefits, effort required, etc.) and the outcome * Nursing to help raise awareness and promote/encourage health consciousness and changes (promote benefits, self-efficacy and assisting in changing environment and barriers) * (Ch 17, Masters, K.—Models and theories focused on nursing goals and functions, pp. 377-405) * Propositions to HPM * https://nursingtheories.weebly.com/nola-pender.html (Links to an external site.) Health Belief Model * Theory of people’s decisions to act in order to prevent/screen/treat illness * 6 main constructs: * Perceived susceptibility (likelihood of getting ill) * Perceived severity (seriousness of consequences) * Perceived benefits (actions reduce possibility of getting ill) * Perceived barriers (costs of taking action greater than benefits) * Cue to action (exposed to factors prompting change/action) * Self-efficacy (confidence in self to achieve success) * (Ch 11, Glanz, K., Burke, L. E., & Rimer, B. K.-Health behavior theories, pp. 235-256) Theory of Reasoned Action: aka theory of planned behavior * Predictability of people to change behaviors * Based on attitudes, social support, self-efficacy and intention ** Individual attitudes = personal opinion or whether behavior is good/bad ** Subjective norms = social pressure/expectations from individual’s perspective *** Individuals normative beliefs: what individual thinks people want or expect *** Individual motivation: persons need to comply with what people think ** Perceived behavioral control = self-efficacy or ability to achieve new or changed behavior * Intention is the predictability that the above beliefs are strong enough to illicit change * (https://www.cleverism.com/theory-of-planned-behavior/)